The prevalence, associated risk factors and pregnancy related outcomes of large for gestational age new-borns delivered at Chris Hani Baragwanath Academic Hospital

Abstract

Background. Large for gestational age (LGA) refers to a newborn birthweight equal to or greater than the 90th percentile for a given gestational age. Delivering an LGA newborn poses a high risk of morbidity and mortality for both mother and baby. Objectives. To describe the prevalence of term LGA newborns and identify the factors and pregnancy-related outcomes associated with delivering term LGA newborns at Chris Hani Baragwanath Academic Hospital (CHBAH), a tertiary hospital in Johannesburg, South Africa. Methods. This was a retrospective, institution-based cross-sectional study from 1 October 2020 to 31 March 2021, in which 275 LGA singleton-term newborn deliveries were reviewed. Patient demographics, medical factors and clinical outcomes were recorded and statistically analysed. Results. The prevalence of LGA newborns in singleton-term deliveries at CHBAH was found to be 3.92%. The associated factors included maternal obesity, multiparity, prolonged pregnancy with a gestational age greater than 40 weeks, a mother’s history of previously birthing an LGA infant and male newborn gender. The maternal complications observed included prolonged labour, increased caesarean delivery, postpartum haemorrhage, obstetric anal sphincter injuries and uterine rupture. The fetal and neonatal complications included shoulder dystocia, neonatal hypoglycaemia, and neonatal respiratory distress syndrome. Conclusions. LGA singleton-term newborn deliveries at CHBAH were associated with both maternal and neonatal morbidity. The presence of associated factors should alert maternity caregivers to closely monitor these pregnancies and plan for an appropriate mode of delivery. Newborns that are LGA should be routinely screened and appropriately managed for hypoglycaemia.